The Difference Between Radiculopathy, Radiculitis, and Radicular

Radiculitis (radiculopathy) is a general term used by doctors to refer to symptoms associated with a pinched or inflamed spinal root. Against the background of lumbar osteochondrosis, a disease such as the radicular of the lumbosacral spine often develops. This clinical syndrome occurs due to compression and damage to the nerve roots. 

This is a widespread disease, more than 10% of the population of our planet are over 40-50 years old, and in the last decade, radiculitis has become younger, occurs in the young age group from 25 to 35 years old, and people involved in professional sports, as well as those who are long-term while sitting at a computer or driving a car.

A radicular syndrome is a complex pathology, the etymology of which can be different. A destructive change in the vertebral discs occurs in stages. Therefore, it is most often diagnosed when pain occurs. This is a complex of clinical manifestations caused by compression of the spinal nerve roots. Sometimes the radicular syndrome is called radiculitis, but there is often no inflammatory process with this disease, so radiculopathy is correct.

Radiculopathy refers to any painful process that occurs in the spinal cord. Radiculitis is inflammation of the spinal cord root. Radicular pain is a symptom of radiculopathy.

Radicular Pain Symptoms and Treatment

Most often, radicular pain syndrome develops due to osteochondrosis. Osteochondrosis disrupts the metabolism and blood circulation in the spine. When the vertebrae is under pressure, the intervertebral discs bulge and can crack. Through the cracks, the semi-liquid nucleus of the disc enters the spinal canal. It pinches the nerve roots and causes radiculopathy.

Osteophytes also compress the roots of the spinal nerves. These bony growths on the vertebrae form when the intervertebral discs get lower to compensate for the height. It also becomes the cause of radicular pain.

The main symptoms of this syndrome:

• The manifestations of the disease differ depending on where the nerve roots are pinched. If this happens in the lumbosacral region, the pain is localized in the lower back, buttocks, and spreads along the thigh. It radiates to the lower leg and foot. A person experiences discomfort while walking and running. Severe pain occurs with a sudden change in position. In the later stages, movement is generally difficult.
• If radiculopathy strikes the cervical spine, radicular pain is localized here. The back of the head, shoulder, and scapula can hurt constantly. The sensation is exacerbated if you turn your head suddenly, cough, or wave your hand. One of the limbs may go numb; there is a “cotton” hand feel. Sudden pain occurs at night.
• If inflammation or pinching of the roots occurs in the thoracic region, the pain will gird the ribs and intensify from deep breaths, bends, and any movements.

Treatment

• To prescribe the correct course of treatment, the doctor determines the stage of the disease considering the sex and age of the patient, his characteristics, and existing diseases.

Causes of Radiculitis

The cause of the development of radiculitis is the pathological processes that occur in the spine, namely:

• Degenerative-dystrophic processes osteochondrosis and its complications – protrusion and hernia of intervertebral discs.
• Malformations of the musculoskeletal system, accompanied by changes in muscle tone.
• Posture disorders, the curvature of the spine, scoliosis.
• Incorrect distribution of physical stress on the spinal nerve root column during a person’s professional activity (when driving a car, for office workers and loaders – with a long stay in one position, loaders).
• A sedentary lifestyle, in which blood supply to the lumbar region muscles gradually increases.
• Improper drinking regime throughout the day and for several months.
• Deficiency of vitamins and minerals leads to osteoporosis and trophic lesions of the nerve fiber.
• Tuberculosis, osteomyelitis, chronic syphilis, and other spinal cord infections.
• Regular injuries to the vertebrae and the soft tissues surrounding them (blows, sharp twists, compression when jumping, sprains of the ligamentous apparatus).
• Overweight with obesity of 1-2 degrees and the presence of bad habits such as smoking, abuse of tea, coffee, and alcoholic beverages.

Diagnosis, Treatment, and Types of Radiculitis

Diagnosis

For the diagnosis of radicular pain, tension symptoms are important. For example, Lasegue’s symptom is characteristic when you raise a straight leg while lying on your back, and pain in the lower back increases.

• An MRI or CT scan of the lumbosacral spine is important for making the correct diagnosis because only these studies will allow the attending physician to identify the presence of diseases such as intervertebral hernias or other diseases of the spine (spondylitis, compression fractures, neoplasms).

Treatment

• The modern approach to treating acute and chronic pain, which includes non-steroidal anti-inflammatory drugs and muscle relaxants. Their mechanism of action: reducing inflammation, pain intensity, and relieving muscle spasms. 
• Also, physiotherapeutic treatment is carried out during the period of remission of the disease (electrophoresis, amplipulse, darsonvalization).

Types of Radiculitis

Cervical radiculopathy. Cervical radiculitis, by its name, indicates the localization of pain in the neck, namely in the cervical spine. This disease is expressed by pain, sensory disturbances, or muscle weakness; it can be right. The causes of cervical radiculitis of the spinal nerve root can be different: disc herniation, disc protrusion, disc degeneration, osteoarthritis, foraminal stenosis, etc. Symptoms can appear in the neck and radiate to other parts of the body.

Thoracic radiculopathy. Thoracic radiculitis means the localization of pain in the middle of the back. Symptoms are typical for this type of disease. The patient may feel pain, tingling, numbness, and muscle weakness. Compared to cervical radiculitis is rare. This is due to the relative rigidity of this part of the spine, which serves as an attachment point for the ribs and supports for the upper and lower trunk. The flexibility of this section prevents the vertebrae and discs from age-related changes. If you have symptoms, you need to see a doctor who will carry out tests and prescribe the correct treatment. Potential reasons for developing this type of pain include the following factors:

• degenerative disc changes, disc protrusion;
• herniated disc;
• osteoarthritis osteophyte;
• spinal injury (especially when twisting);
• spinal stenosis;
• foraminal stenosis.

Lumbar radiculopathy. The lumbar has its localization in the lower back, where the center of gravity of the human body is located. The signs of this type of radiculitis are similar to other departments. The term lumbar radiculopathy refers to irritation of the large sciatic nerve. The most striking symptom of this type of disease is intense pain in the buttocks, thighs, and feet. The main causes of lumbar radiculopathy are:

• arthritis;
• degenerative changes in the vertebrae;
• foraminal stenosis;
• compression fracture;
• herniated disc;
• disc protrusion;
• spondylolisthesis.

The symptoms of sciatica and spinal stenosis are very similar. In addition, these diseases are related, so to understand the full picture. You also need to know what spinal stenosis is.

What is Spinal Stenosis?

Spinal stenosis is pathological and its abnormal narrowing. It occurs in the central, lateral zone, or intervertebral foramen area. The disease is based on the compression of nerve fibers by soft and bone tissues penetrating the canal cavity.

Due to compression of the spinal cord or nerves, a neurological deficit develops, manifested by a typical clinical picture and radicular pain. Most patients suffer from radicular pain and sensory disorders. The localization of discomfort depends on the level of damage to the spinal cord and the nervous system. In 80-90% of cases, the disease develops in the lumbar spine.

Spinal stenosis is a pathology characterized by a gradual development; this contributes to the timely diagnosis of the disease, followed by the selection of adequate treatment. In 85-90% of cases, unpleasant symptoms can be eliminated with conservative therapy. Only with the ineffectiveness of medications is a planned neurosurgical operation prescribed.

Types of stenosis. In the first case, the reason for the pathology is anomalies in the development of the spine, fusion of intervertebral discs, additional bone structures on their surface, and hypertrophy of the ligamentous apparatus that fixes the vertebrae. All these changes lead to a narrowing of the lumen with the development of a characteristic clinical picture.

In most cases (up to 80%), the disease is acquired (secondary) in nature. Pathology develops against the background of degenerative processes in the spine due to various reasons.

Depending on the etiology, secondary stenosis of the canal is:

• post-traumatic;
• postoperative;
• a consequence of an infectious process;
• the result of other degenerative diseases of the spine (spondylosis, facet joints, scoliosis, lordosis).

Depending on the nature of the compression of nerve fibers and pain, neurosurgeons distinguish central, lateral, and foraminal (in the intervertebral foramen area).

Symptoms and Causes of Spinal Stenosis 

It is characterized by damage to the fibers that pass inside and spread to the peripheral parts of the body. A violation of their function accompanies compression of the nerve of microvessels, and lymphatic pathways that supply these structures with nutrients. As a result, ischemia, edema, and demyelination develop, impairing the transmission of impulses along the affected fibers. Against the background of these changes, the patient presents the following complaints:

• Pain in the affected spinal area. The connection between the radicular pain syndrome and the patient’s physical activity is characteristic. Discomfort increases with movements accompanied by a narrowing of the intervertebral foramen (extension, walking downstairs, prolonged stay in an upright position).
• Violation of sensitivity. The patient may complain about the inability to identify objects by touch and deterioration in the perception of heat and cold on the skin.
• Muscle weakness, deterioration of motor skills, coordination of movements.
• Paresthesia, goosebumps.

The clinical picture directly depends on the localization of the maximum compression. In 75-90% of cases, the disease develops in the lumbar region, causing the predominant lesion of the lumbar, gluteal region, and lower extremities.

The severity of the symptom depends on the degree of compression of the spinal nerve roots and fibers. Patients note a decrease in discomfort while squatting and its increase with active walking or extension of the spine. Discomfort can extend to the back of the lower extremities, accompanied by a loss of patient stability. The pain is permanent in this case.

Stenosis Causes 

The pathogenetic basis for the development of the disease is the mechanical compression of nerve fibers that pass inside the spinal canal or in the places where the spinal nerves originate.

The most common reason of pathology:

• congenital malformations of the spine;
• traumatic injuries of the spinal canal, including surgery;
• infections with damage to the central and peripheral nervous system;
• an overgrowth of osteophytes (bone processes) against the background of osteoarthritis;
• scoliosis, lordosis;
• ankylosing spondylitis;
• the formation of facet joints;
• spinal cord ligament hypertrophy;
• intervertebral disc pathology;
• spondylolysis and/or spondylolisthesis.

Stenosis of the intervertebral canal is a disease that develops gradually. In 90% of cases, pathology is a consequence of another disease. However, some factors increase the risk of developing this problem:

• obesity;
• spinal injury;
• heavy physical activity (weightlifters, loaders);
• metabolic disorders (diabetes mellitus);
• menopause in women.

According to statistics, the disease develops in 1-2% of the world’s population. It is mostly men over the age of 50 who are affected.

Prevention and Rehabilitation of Radiculopathy and Radicular Pain

Prevention

There is no specific prophylaxis. The patient is left to work with risk factors, which include:

• body weight control;
• timely treatment of diseases of the spine;
• dosed physical activity;
• avoidance of traumatic injury;
• regular check-ups with a doctor.

When the first signs of the disease are detected, it is necessary to seek specialized help as early as possible.

Rehabilitation

It takes place on an inpatient and outpatient basis.

•  For the first few days, the patient remains under the supervision of a neurosurgeon, who daily performs dressings and assesses the quality of postoperative wound healing. 
• After discharge, the patient gradually returns to normal life.
• The stitches are removed on the 7-10th day. 
• Full recovery occurs within 1-6 months, depending on the duration of the disease and the volume of surgical intervention. 
• At this time, limiting physical activity and stress factors is recommended. 
• You need to eat well, have a rest, and follow the recommendations of the neurosurgeon.

Hopefully, all this information has been useful for you. Take care of yourself.

 FAQ

• What is spinal radiculopathy?

Radiculopathy is also called radiculitis or radicular syndrome. This is a condition in which the nerve roots of the spinal cord are pinched or inflamed. The disease is characterized by rapid development and prevalence.

• What is Radicular Syndrome?

This is a complex of clinical manifestations caused by compression of the spinal nerve roots. Sometimes the radicular syndrome is called radiculitis, but there is often no inflammatory process with this disease, so radiculopathy is correct.

• What are the radicular syndrome signs?

The main symptom that characterizes radicular syndrome is pain along the affected nerve. The pain is mild at first, but the more the root is squeezed, the stronger the pain will be. The structure that pinches the root will shift with stress or movement, and the pain will be more severe.

• Which doctor treats spinal stenosis?

Spinal stenosis is a disease that a neurosurgeon treats. But you can get a complete examination.

• Can spinal stenosis be cured?

It is impossible to eliminate the disease with the help of pills completely. However, adequate drug therapy can provide long-term remission and normalize the patient’s well-being for many years.

• How to prevent the development of spinal stenosis?

Prevention is aimed at combating risk factors for obesity, excessive physical activity, and spinal injury. Timely treatment of other pathologies of the musculoskeletal system remains an important aspect.

• Is Spinal stenosis a serious disease?

If the symptoms are ignored, and if treatment is not provided, spinal stenosis can have serious consequences. If the spinal nerve root is compressed long enough, irreversible effects and paralysis can occur.